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Maryland rates for HCPCS J0133

Injection, acyclovir, 5 mg

Facilitymedian $34 · 10th–90th $9$2190%10%20%10th90th$34Professionalmedian $0 · 10th–90th $0$00%50%10th90th$0$0.0$0.1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.91 / $33.88 / $218.78
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.12 / $0.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.12 / $0.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $0.12 / $0.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.04 / $0.12 / $0.15
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.12 / $0.12 / $0.12